Politics Underlies Support for Universal Coverage

Two newspapers recently published opinion pieces examining presidential candidates' health care proposals. Summaries appear below.

• Kul Rai, Hartford Courant: "Leading presidential candidates who support universal health care" -- Sens. Hillary Rodham Clinton (D-N.Y.) and Barak Obama (D-Ill.), former Sen. John Edwards (D-N.C.) and former Massachusetts Gov. Mitt Romney (R) -- "perhaps do so as a campaign strategy to win votes rather than to overhaul health care," Rai, professor emeritus of political science at Southern Connecticut State University, writes in a Courant opinion piece. According to Rai, U.S. legislators "are far too independent to vote as a bloc" on such "drastic policy changes," and "in no other country in the world are interest groups so powerful as in the U.S." He continues, "Some major changes in health care to cover the most vulnerable in society, especially children, will likely be introduced in 2009." However, if universal health coverage legislation is proposed, "we can expect the same kind of fatal onslaught on it by insurance companies, pharmaceutical companies, small and large businesses, doctors and hospitals as happened in 1993 when Bill (and Hillary) Clinton attempted to introduce universal health care," Rai writes (Rai, Hartford Courant, 7/2).
• Ronald Brownstein, Los Angeles Times: Democratic presidential candidates "are hoping to avoid ... a direct collision" with health insurance companies -- as happened in the 1990s with the Clintons' proposal to overhaul the U.S. health system -- by proposing regulations that would allow insurers "to continue operating but under new rules," Brownstein writes in a Times opinion piece. Democrats' ideas "could force the insurance companies to compete less by selecting risk -- that is, trying to avoid selling policies to people with expensive health needs -- and more by producing better health care results at lower cost," according to Brownstein. Meanwhile, Republican candidates maintain that "'liberating'" insurers "is the best way to increase competition and ultimately reduce costs," Brownstein writes. The health insurance industry "may be a wild card in the next stage of reform," Brownstein writes, adding, "If it allies solely with Republican liberators, it could block all the plans of the regulators," but "Democrats might be able to attract at least portions of the industry with a package that expands coverage for the uninsured (which, after all, means more business for insurers) while weaning the companies from the practices that generate the most backlash (like denying coverage to those who need it most)" (Brownstein, Los Angeles Times, 7/1).